The MDPHnet Distributed Querying for Public Health Surveillance

Transcription

1 The MDPHnet Distributed Querying for Public Health Surveillance NIH Health Care Systems Collaboratory Grand Rounds Automated Disease Surveillance Using Electronic Health Record Data June 28, 2013 Jeffrey Brown, PhD Harvard Medical School and Harvard Pilgrim Health Care Institute Boston, MA 1

2 Distributed Querying Guiding Principles Data partners maintain control and analyze their data Standardize the data using a common data model Data partners ongoing involvement is crucial Little to no exchange of person level data required Secondary use can t interfere with primary use Few data elements are needed Distribute code to partners for local execution Provide results, not data, to requestor 2

3 PopMedNet Architecture Deployment Overview Internet System Administrator (Two Factor AuthN) Secure Network Portal Data Administrators & Reviewers (Two Factor AuthN) HTTPS, TLS Data Partner Organization Internet HTTPS, TLS Firewall Network Security (IDS/IPS, VPN/RSA) Web Servers / Reverse Proxies/Load Balancers User and DataMart Provisioning And Administration DataMart Management (Metadata, Authorization) User Account Management (Groups/Roles/User Accounts) PopMedNet Workflow Job Scheduling Request/ Response Mgr User Interface Query Interface Firewall HTTPS, Mutual TLS Optional Site to Site VPN Firewall DMZ Data Mart Client Optional REST Internal Data Source (Common Data Model) ETL DataWarehouse / Repositories DMZ Non DMZ (Internal Components) Investigator Enhanced Investigator Observer FISMA Compliant Data Center Audit PMN Software Supports multiple deployment models Agnostic to data center infrastructure and complements existing network infrastructure VM based deployments enabling ease of disaster recovery and planning Seamless overlay of VPN Connections (Remote Access, Site to Site, Two Factor User Authentication) Supports consolidation of remote sites into the data center for central management (Data Partner Components can be hosted in a central data center similar to the PMN Portal) Secure End to End connection (Encrypted Transport using X.509 certificates) Supports industry standard RBAC configuration for users Supports Data Source provisioning based on RBAC and additional data source specific metadata Data Partners execute queries using PULL model instead of PUSH model 3

4 PopMedNet: Current Networks and Partners Data Partner Funder AHRQ FDA NCI ONC SPAN PEAL Mini Sentinel CRN MDPHnet HMORNnet HMO Research Network (# sites in each network) (11) (4) (13) (9) (12) Vanderbilt Aetna Humana Optum (UnitedHealthCare) WellPoint (HealthCore) MA League of Community Health Centers Atrius Beth Israel Deaconess Medical Center (Query Health Pilot) CHORDS and NIH Collaboratory coming soon 4

5 PopMedNet.org 5

6 MDPHnet 6

7 MDPHnet Overview ONC funded, coordinated by MA ehealth Collaborative Distributed public health surveillance query capability for Massachusetts DPH Based on the ESP data model 2 large medical group practices MDPHnet launched in November active investigators have issued several hundred queries 7

8 Current Querying Capabilities Menu driven queries Menu driven Query Composer Reportable Disease queries based on ESP case identification Ad hoc SQL Request scheduler Stratification by sex, age, race, period, and location 8

9 MDPHnet Query Tool 9

10 Login 10

11 Home Page 11

12 Select A Request Model: ESP Query Builder

13 Select A Query Type: Query Composer

14 Query Composer Query meta data 14

15 Query Composer Query Scheduler 15

16 Scheduler Query Scheduler

17 Query Composer Query Composer 17

18 Query Composer: Define Criteria Group(s) Create one or more cohorts ( criteria groups ) Terms inside the group are OR ed Groups are AND ed Groups can be inclusion or exclusion For example, identify patients over 25 yo of any race with diabetes who had at least 2 visits who DID NOT have any diagnoses for hypertension or stroke during the same period AND who had a diagnosis of stroke in

19 ESP Query Composer: Report Parameters 19

20 Select Data Providers to Query

21 SQL Query Create ad hoc SQL code to execute against ESP data model Insert code and distribute 21

22 Results Page on Portal

23 Results

24 Potential for the NIH Distributed Research Network 24

25 NIH Distributed Research Network Coordinating Center Network Management Query Support Knowledge Database Project Management Consultation Research Support Query Tool Development Software Development Data Models & Standards Health System Expertise NIH DRN Secure Portal Knowledge Management System Cross project lessons learned, query tracking, meta data capture, search functions, etc PROJECTS Feasibility Project 2 Project 3 Modular Programs Summary Tables Query Interface Query Tools SAS, SQL, menu driven Analytic Tools Reporting Tools Administration Security \ Access Control File \Query Repository User Administration Workflow Management Mini Sentinel Site A Mini Sentinel Site B CTSA 1 CTSA 2 Health Plan 1 Health Plan 2 PBRN 1 Registry 1 Medical Practice 1 Hospital 1 Research dataset 1

26 NIH Distributed Research Network Coordinating Center Network Management Query Support Knowledge Database Project Management Consultation Research Support Query Tool Development Software Development Data Models & Standards Health System Expertise NIH DRN Secure Portal Knowledge Management System Cross project lessons learned, query tracking, meta data capture, search functions, etc PROJECTS Feasibility Modular Programs Summary Tables Query Interface Query Tools SAS, SQL, menu driven Analytic Tools Reporting Tools Administration Security \ Access Control File \Query Repository User Administration Workflow Management Mini Sentinel Site A Mini Sentinel Site B CTSA 1 CTSA 2 Health Plan 1 Health Plan 2 PBRN 1 Registry 1 Medical Practice 1 Hospital 1 Research dataset 1

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29 Thank You For more information: PopMedNet : popmednet.org ESP: esphealth.org Jeff_brown@hphc.org 29

30 Query Composer: Request Via Wizards

31 DataMart Administrator Processes Request Administrative workflow in box

32 DataMart Administrator Processes Request Administrator can review query input

33 DataMart Administrator Processes Request and output, and sends results back to the requestor

34 Or Downloads